Patient monitoring systems and messages that send alerts to patients only when the patient is awake

ABSTRACT

A system for is provided for using telemetry data based on patient habit information or patient monitoring. One or more patient monitoring devices has a unique patient ID. The one or more monitoring devices acquire patient information selected from of at least one of, a patient&#39;s activities, behaviors and habit information, and patient monitoring. ID circuitry is at the patient monitoring device. The ID circuitry includes ID storage, a communication system that reads and transmits the unique ID from an ID storage, a power source and a pathway system to route signals through the circuitry. An alarm is at the patient monitoring device that provides an alert only when the patient is in a wake-state. A telemetry system is in communication with the patient monitoring device. The telemetry system includes a database of patient ID&#39;s.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation in part of U.S. Ser. No. 13/923,909,U.S. Ser. No. 13/923,637, U.S. Ser. No. 13/923,614, U.S. Ser. No.13/923,809, U.S. Ser. No. 13/923,750, U.S. Ser. No. 13/923,583, U.S.Ser. No. 13/923,560, U.S. Ser. No. 13/923,543, and U.S. Ser. No.13/923,937, all filed Jun. 21, 2013 and all of which claim the benefitof U.S. 61/772,265, U.S. 61/812,083 and 61/823,502. All of theabove-identified applications are fully incorporated herein byreference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention is directed to patient monitoring devices andtelemetry systems, and more particularly to intelligent, patientmonitoring devices with unique ID's for each patient that sends alertsto patients only when the patient is awake.

2. Description of the Related Art

Patient monitoring was accomplished by electronic equipment maintainedat the patient's bedside. Vital signs derived from physiologicalwaveforms were monitored with the bedside equipment and alarms weregenerated if predetermined limits were exceeded by the vital signs. Thisbedside monitoring equipment became larger, more complex and expensiveas each bedside unit undertook to monitor more physiological data andprovide more sophisticated displays, e.g. color, more and bettercommunications and more in-depth analysis of the data, such ascalculation of vital signs and trends which required memory andprocessing capability. The provision of such units at each appropriatepatient bedside introduces considerable additional expense to thehospital patient care costs.

With the introduction of bedside monitoring units, attempts were made toprovide a measure of remote monitoring by transmitting analog waveformsof physiological data from the bedside unit to equipment at a centralstation such as a nurse's station. Subsequently remote monitoringefforts included analog waveforms plus digital representations fordisplay. Both the bedside and remote monitoring activity acted to givealarms upon sensing an abnormal condition and to store data and analyzedata to obtain vital signs and trends. But these systems are basicallyone-way systems reporting physiological data from the patient. There isno communication with the patient as a part of an interactive integratedsystem.

Telemetry systems can be implemented to acquire and transmit data from aremote source. Some telemetry systems provide information about apatient's activities.

It is becoming commonplace to use wireless packet data service networksfor effectuating data sessions with. In some implementations, uniqueidentifications (ID) need to be assigned to the devices in order tofacilitate certain aspects of service provisioning, e.g., security,validation and authentication, et cetera. In such scenarios, it becomesimperative that no two devices have the same indicium (i.e., collision).Further, provisioning of such indicia should be flexible so as tomaintain the entire pool of indicia to a manageable level while allowingfor their widespread use in multiple service environments.

Medical telemetry systems may comprise an alarm adapted to identify highrisk patients and/or patients requiring special assistance. Some medicalprocedures and diagnostic examinations require the removal of anytelemetry system components attached directly to a patient. One problemwith conventional medical telemetry systems is that the process ofremoving telemetry system components for purposes of performing amedical procedure or diagnostic examination can generate a false alarm.False alarms unnecessarily tax hospital resources and interfere with theworking environment.

There is a need for telemetry devices configured to be used in patientmonitoring. There is a further need for monitoring devices that sendalerts to patients only when the patient is awake.

SUMMARY OF THE INVENTION

An object of the present invention is to provide improved patientmonitoring systems, and their methods of use.

Another object of the present invention is to provide a system, and itsassociated methods of use, that includes a patient monitoring devicethat gathers telemetry data based on a patient's habits, patientcondition or patient parameter in communication with a telemetry system,that sends alerts to the patient only when the patient is awake.

A further object of the present invention is to provide systems, andtheir associated methods of use, that use a patient monitoring device orsystem that measures and tracks everything from a patient's movementsand activities, to habits, lifestyle choices, health and socialinteractions, and only sends to alerts to the patient when the patientis alert.

Yet another object of the present invention is to provide telemetrysystems, and their associated methods of use, in communication with apatient monitoring device that creates a unique portrait of a patient,and provides personalized information and mapping of a patient's dailyexperience, with alerts only being sent to the patient when the patientis alert.

These and other objects of the present invention are achieved in asystem for using telemetry data based on a patient habit information orpatient monitoring. One or more patient monitoring devices has a uniquepatient ID. The one or more monitoring devices acquire patientinformation selected from of at least one of, a patient's activities,behaviors and habit information, and patient monitoring. ID circuitry isat the patient monitoring device. The ID circuitry includes ID storage,a communication system that reads and transmits the unique ID from an IDstorage, a power source and a pathway system to route signals throughthe circuitry. An alarm is at the patient monitoring device thatprovides an alert only when the patient is in a wake-state. A telemetrysystem is in communication with the patient monitoring device. Thetelemetry system includes a database of patient ID's.

In another embodiment of the present invention, a method is provided forusing telemetry data is acquired based on a patient habit information orpatient monitoring. The patient information is selected from of at leastone of, a patient's activities, behaviors and habit information, andpatient monitoring. A unique ID of the patient is sent from themonitoring device to a telemetry system. An alert is sent when thepatient is in a wake-state.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1( a) and 1(b) illustrate one embodiment of a wearable device ofthe present invention, where one size fits all.

FIG. 2 illustrates one embodiment of electronics that can be included inthe wearable device.

FIG. 3 illustrates one embodiment of a telemetry system of the presentinvention.

FIG. 4 is a diagram of the programming input schematic of the securesensor/transmitter array of FIG. 7.

FIG. 5 is a block diagram of the system of programming thesensor/transmitter(s) comprising the secure sensor/transmitter array ofFIG. 7.

FIG. 6 is a block diagram of the jam command and security/randomizationbits of the secure sensor/transmitter array of FIG. 7.

FIG. 7 is a logic circuit diagram of the sensor/transmitter programminginput schematic in one embodiment of the present invention.

FIG. 8 is a block diagram of an embodiment of a computer implementedsystem for determining the location of a remote sensor utilizing themethods of the present invention.

FIG. 9 is a block diagram illustrating one embodiment of a SNAPSHOT GPSreceiver for use according to the present invention.

FIG. 10 is a block diagram of a remote sensor shown in communicationwith two different external communication devices.

FIG. 11 is a diagram of the active RF and RF backscatter antennas.

FIG. 12 is a diagram of the encoding scheme for the symbols in theactive RF protocol.

FIG. 13 is a diagram of the packet structure in the IRDA protocol.

FIG. 14 is a diagram of the encoding scheme in the IRDA protocol.

FIG. 15 illustrates one embodiment of a wireless network that can beused with the present invention.

FIGS. 16( a)-16(d) illustrate various embodiments of the interaction ofa wearable device of the present invention with an interaction engine, atransaction engine, a decoding engine, and a payment system and a thirdparty.

FIG. 17 illustrates an embodiment of a social network circle with socialdevices in accordance with one embodiment of the present invention.

FIG. 18 illustrates an embodiment of a social group with a variety ofmembers in accordance with one embodiment of the present invention.

FIG. 19 is a functional block diagram illustrating a social networkinfrastructure and social devices in accordance with one embodiment ofthe invention.

FIG. 20 illustrates a simplified block diagram of a client-server systemand network in one embodiment of the present invention.

FIG. 21 illustrates a more detailed diagram of an exemplary client orserver computer that can be used in one embodiment of the presentinvention.

FIG. 22 illustrates a system for activity collection and building asocial graph including sharing activity between users in one embodimentof the present invention.

FIG. 23 illustrates a social graph with nodes representing users andedges representing sharing activity between the users in one embodimentof the present invention.

FIG. 24 illustrates a flow illustrating operation of an alarm in oneembodiment of the present invention that sends alerts to the patientonly when the patient is awake.

DETAILED DESCRIPTION

As used herein, the term engine refers to software, firmware, hardware,or other component that can be used to effectuate a purpose. The enginewill typically include software instructions that are stored innon-volatile memory (also referred to as secondary memory). When thesoftware instructions are executed, at least a subset of the softwareinstructions can be loaded into memory (also referred to as primarymemory) by a processor. The processor then executes the softwareinstructions in memory. The processor may be a shared processor, adedicated processor, or a combination of shared or dedicated processors.A typical program will include calls to hardware components (such as I/Odevices), which typically requires the execution of drivers. The driversmay or may not be considered part of the engine, but the distinction isnot critical.

As used herein, the term database is used broadly to include any knownor convenient means for storing data, whether centralized ordistributed, relational or otherwise.

As used herein a mobile device includes, but is not limited to, a cellphone, such as Apple's iPhone®, other portable electronic devices, suchas Apple's iPod Touches®, Apple's iPads®, and mobile devices based onGoogle's Android® operating system, and any other portable electronicdevice that includes software, firmware, hardware, or a combinationthereof that is capable of at least receiving the signal, decoding ifneeded, exchanging information with a transaction server to verify thebuyer and/or seller's account information, conducting the transaction,and generating a receipt. Typical components of mobile device mayinclude but are not limited to persistent memories like flash ROM,random access memory like SRAM, a camera, a battery, LCD driver, adisplay, a cellular antenna, a speaker, a BLUETOOTH® circuit, and WIFIcircuitry, where the persistent memory may contain programs,applications, and/or an operating system for the mobile device.

As used herein, the terms “social network” and “SNET” comprise agrouping or social structure of devices and/or individuals, as well asconnections, links and interdependencies between such devices and/orindividuals. Members or actors (including devices) within or affiliatedwith a SNET may be referred to herein as “nodes”, “social devices”,“SNET members”, “SNET devices”, “user devices” and/or “modules”. Inaddition, the terms “SNET circle”, “SNET group” and “SNET sub-circle”generally denote a social network that comprises social devices and, ascontextually appropriate, human SNET members and personal area networks(“PANs”).

A used herein, the term “wearable device” is anything that can be wornby an individual and that has a back side that in some embodimentscontacts a user's skin and a face side. Examples of wearable deviceinclude but are not limited to a cap, arm band, wristband, garment, andthe like.

As used herein, the term “computer” is a general purpose device that canbe programmed to carry out a finite set of arithmetic or logicaloperations. Since a sequence of operations can be readily changed, thecomputer can solve more than one kind of problem. A computer can includeof at least one processing element, typically a central processing unit(CPU) and some form of memory. The processing element carries outarithmetic and logic operations, and a sequencing and control unit thatcan change the order of operations based on stored information.Peripheral devices allow information to be retrieved from an externalsource, and the result of operations saved and retrieved.

As used herein, the term “Internet” is a global system of interconnectedcomputer networks that use the standard Internet protocol suite (TCP/IP)to serve billions of users worldwide. It is a network of networks thatconsists of millions of private, public, academic, business, andgovernment networks, of local to global scope, that are linked by abroad array of electronic, wireless and optical networking technologies.The Internet carries an extensive range of information resources andservices, such as the inter-linked hypertext documents of the World WideWeb (WWW) and the infrastructure to support email. The communicationsinfrastructure of the Internet consists of its hardware components and asystem of software layers that control various aspects of thearchitecture.

As used herein, the term “extranet” is a computer network that allowscontrolled access from the outside. An extranet can be an extension ofan organization's intranet that is extended to users outside theorganization that can be partners, vendors, and suppliers, in isolationfrom all other Internet users. An extranet can be an intranet mappedonto the public Internet or some other transmission system notaccessible to the general public, but managed by more than one company'sadministrator(s). Examples of extranet-style networks include but arenot limited to:

-   -   LANs or WANs belonging to multiple organizations and        interconnected and accessed using remote dial-up    -   LANs or WANs belonging to multiple organizations and        interconnected and accessed using dedicated lines    -   Virtual private network (VPN) that is comprised of LANs or WANs        belonging to multiple organizations, and that extends usage to        remote users using special “tunneling” software that creates a        secure, usually encrypted network connection over public lines,        sometimes via an ISP

As used herein, the term “Intranet” is a network that is owned by asingle organization that controls its security policies and networkmanagement. Examples of intranets include but are not limited to:

-   -   A LAN    -   A Wide-area network (WAN) that is comprised of a LAN that        extends usage to remote employees with dial-up access    -   A WAN that is comprised of interconnected LANs using dedicated        communication lines    -   A Virtual private network (VPN) that is comprised of a LAN or        WAN that extends usage to remote employees or networks using        special “tunneling” software that creates a secure, usually        encrypted connection over public lines, sometimes via an        Internet Service Provider (ISP)

As used herein, the term (patient monitoring) includes: (i) Cardiacmonitoring, which generally refers to continuous electrocardiographywith assessment of the patient's condition relative to their cardiacrhythm. A small monitor worn by an ambulatory patient for this purposeis known as a Holter monitor. Cardiac monitoring can also involvecardiac output monitoring via an invasive Swan-Ganz catheter (ii)Hemodynamic monitoring, which monitors the blood pressure and blood flowwithin the circulatory system. Blood pressure can be measured eitherinvasively through an inserted blood pressure transducer assembly, ornoninvasively with an inflatable blood pressure cuff. (iii) Respiratorymonitoring, such as: pulse oximetry which involves measurement of thesaturated percentage of oxygen in the blood, referred to as SpO2, andmeasured by an infrared finger cuff, capnography, which involves CO2measurements, referred to as EtCO2 or end-tidal carbon dioxideconcentration. The respiratory rate monitored as such is called AWRR orairway respiratory rate). (iv) Respiratory rate monitoring through athoracic transducer belt, an ECG channel or via capnography, (v)Neurological monitoring, such as of intracranial pressure. Specialpatient monitors can incorporate the monitoring of brain waveselectroencephalography, gas anesthetic concentrations, bispectral index(BIS), and the like, (vi) Blood glucose monitoring using glucosesensors. (vii) Childbirth monitoring with sensors that monitor variousaspects of childbirth. (viii) Body temperature monitoring which in oneembodiment is through an adhesive pad containing a thermoelectrictransducer. (ix) Stress monitoring that can utilize sensors to providewarnings when stress levels signs are rising before a human can noticeit and provide alerts and suggestions. (x) Epilepsy monitoring. (xi)Toxicity monitoring, and the like.

Additionally the present invention can be used to detect differences fora variety of blood tests, including but not limited to tests for thefollowing: sodium, potassium, chloride, urea, creatinine, calcium,albumin, fasting glucose, amylase, carcinoembryonic antigen,glycosylated hemoglobin, hemoglobin, erthrocytes hemoglobin and thelike.

For purposes of the present invention, the Internet, extranets andintranets collectively are referred to as (“Network Systems”).

For purposes of the present invention, the Internet, extranets andintranets collectively are referred to as (“Network Systems”).

In various embodiments, the present invention provides a patientmonitoring device 10, such as a wearable device, where one size fitsall. As illustrated in FIGS. 1( a) and 1(b), in one embodiment of thepresent invention, the patient monitoring device 10 include a pluralityof magnets 12, with adjacent magnets having opposite polarity, with alength suitable to be worn by all people. In one embodiment, the lengthof the patient monitoring device 10 can be 10-12 inches. The magnets 12are positioned along an interior of the patient monitoring device 10 tobe provided for good conformation to a user's wrist.

One or more sensors 14 are coupled to the patient monitoring device 10.The sensors are measuring devices. As a non-limiting example, themeasuring device or sensors 14 can include RTSS devices to detect auser's activities, motions, physical parameters, and the like, includingbut not limited to, a heart rate monitor, a body temperature probe, aconventional pedometer, an accelerometer and the like.

Alternatively, multifunctional sensors 14 which can perform all theaforementioned functions of RTSS may be attached or embedded in patientmonitoring device 10. In one embodiment, each sensor can be incommunication and or connect electronically and/or RF to a telemetrymodule 16. A variety of different sensors 14 can be utilized, includingbut not limited to, an accelerometer based sensor, and pressure basedsensors, voltage resistance sensor, a radio frequency sensor, and thelike, as recited above.

As a non-limiting example, an accelerometer, well known to those skilledin the art, detects acceleration and thus user activity. Theaccelerometer provides a voltage output that is proportional to thedetected acceleration. Accordingly, the accelerometer senses vibration.This voltage output provides an acceleration spectrum over time; andinformation about loft time can be ascertained by performingcalculations on that spectrum. A microprocessor subsystem, such asdisclosed in U.S. Pat. No. 8,352,211, incorporated herein by reference,stores the spectrum into memory and processes the spectrum informationto determine activity. Other examples of suitable accelerometer sensorsare disclosed in EP 2428774 A1, incorporated herein by reference.Suitable pressure sensors are disclosed in EP 1883798 B1, incorporatedherein by reference. A suitable voltage resistance sensor is disclosedin EP 1883798 B1, incorporated herein by reference. A suitable radiofrequency sensor is disclosed in EP 2052352 B1, incorporated herein byreference.

Referring to FIG. 2, in various embodiments, the patient monitoringdevice 10, also known as the patient monitoring device, can include apower source 24, such a battery that can be rechargeable. The battery 24can be put into a sleep state when not actively used in order topreserve power. A wake up feature allows the battery 24 and otherelectronics of the patient monitoring device 10 to “sleep” duringnon-use or and is initiated into the “wake up” mode by certainpredestinated events.

In one embodiment, as illustrated in FIG. 3, a telemetry system server16 is coupled to a database 18. Each patient monitoring device 10 isassigned its own unique identification, ID.

The data transmitted by the patient monitoring device 10 sensors 14 andits ID may be coded by appending a seed to digital data bits. Asillustrated in FIG. 3 central processor unit 20 (CPU) validates orrejects received upon detection of the seed string appended to thedigital data bits. In the alternative, the digital data bits may becoded and decoded by applying a scrambling algorithm utilizing the seed.A programming device 22 may be configured to transmit data to a sensor14, also known as a patient monitoring device, utilizing a variety ofalternative transmission means, including, for example, RF, IR, optical,and the like, or a magnetic loop/induction system.

In one embodiment, sensors 14 are configured to be shipped to users in anon-programmable mode with all programming already performed at thefactory. A random seed may be communicated to the programming device 22can a variety of different mechanisms, including but not limited to, viascanning a bar code, manual input, magnetic strip, random numbergeneration, and the like.

Referring again to FIG. 2, in one embodiment, the patient monitoringdevice 10 includes a control unit 26 that puts the patient monitoringdevice 10 in a low power state. A monitoring system 28 can be includedthat remains active. The monitoring system 28 wakes up the electronics30 in the patient monitoring device 10 from a low power state. Thecontrol unit 26 can be notified of awaking of the other components bythe monitoring system 28. The control unit 26 can set a status bit onthe monitoring system 28 only when the battery 24 needs to be in a fullpower state. The control unit 26 then forces a power cycle.

Referring to FIG. 3, one embodiment of a telemetry system 32 isillustrated. The telemetry system 32 is in the communication with thesensors 14 and or patient monitoring device 14 and ID of the patientmonitoring device 10 and can include one or more receivers 34, a centralserver 36 with the CPU 20. The telemetry system 32 can optionallyinclude a display 42 and an alarm 44. The telemetry system 32 receivesinformation from sensors 14 and or the monitoring device of a user'shabits, activities, and the like, and then processes this information.Patient monitoring device 10 with its unique ID and sensors 14 isassigned to a specific user in order to track and/or monitor that user.For illustrative purposes assume that three users A, B AND C are beingtracked and monitored by the telemetry system 32. It should, however, beappreciated that the telemetry system 32 may be implemented to trackand/or monitor a much larger number of users.

In one embodiment of the present invention, radio frequency (RF) devicesthat are sensors 14 and/or chips may serve as the identifying devices.Each source, sensor 14, ID and the like can carry a fixed radiofrequency chip encoded with identifying data which may be correlated tothe individual participants, parts or objects.

Telemetry system 32 of the present invention may include a Real-TimeLocation System (RTLS) 46 and Real-Time Sensing System (RTSS) 48 with RFtechnology. The RF technology may include active and/or passive RFIDsensors 14 and an RF wireless array system as a receiver 34. The RFtechnology in the RTLS 46 and RTSS 48 may include UWB technology (e.g.,IEEE 802.15), WLAN technology (e.g., IEEE 802.11), SAW RFID positioningsystem technology, GPS technology, and the like.

The sensors 14 may communicate directly with each other and/or relaytelemetry data directly to base receiving RF device(s) or base receivers34. The base receivers 34 may forward the telemetry data to a basecomputer either through a direct link or through a network.Alternatively the telemetry data may be forwarded to end user devices,including but not limited to, laptops, mobile devices and the like,either directly or through a network. The comprehensive telemetry system32 using RF technologies such as UWB, ZigBee, Wi-Fi, GPS data system canbe utilized as described above.

The readers/antennae may be interconnected using a LAN, such as Ethernetto provide a network communication infrastructure for the computers andservers. Active and passive RFID sensors 14 may be employed. The activesensors 14 (RFID) may have a two-way communication function, whichallows the base computer system to dynamically manage the sensors 14;vary update rates; send self-identification and telemetry data.

The active sensors 14 may employ dual-radio architecture. In oneembodiment, active sensors 14 transmit radio pulses, which are used todetermine precise two-dimensional or three-dimensional location and aconventional bi-directional radio, which is used as a control andtelemetry channel with a sensor update rate.

The patient monitoring device 10 gathers telemetry data, communicatesthat data to a base station, BLUETOOTH® enabled device, or smart phoneand the like. From the base station, the patient monitoring device 10can receive firmware updates or via a BLUETOOTH® enabled device. Thepatient monitoring device 10 can receive updates wirelessly. The basestation can receive firmware updates from Network Systems, taketelemetry data from the patient monitoring device 10 and transfer it toNetwork Systems. Telemetry data received from the base station isanalyzed by servers and presented to an end user. Any third party devicecan receive data from the patient monitoring device 10 wirelessly anddeliver information to the servers for processing.

In one embodiment, the patient monitoring device 10 uses anaccelerometer, gyroscope, GPS sensor, a BLUETOOTH® chip, and a heartrate monitor.

As a non-limiting example, for heart monitoring, the accelerometer,sensor 14, determines when to sample the sensors 14 and to improve theaccuracy of the heart rate monitor. The gyroscope detects movement andorientation and the GPS sensor is used to determine location of theuser. A BLUETOOTH® chip allows the device to connect wirelessly to otherthird party devices.

As a non-limiting example, a heart rate monitor 14 detects the user'sheart rate in order to accurately determine the user's activity level,behavioral patterns and the like.

An Artificial Intelligence (AI) or Machine Learning-grade algorithms isused to identify the user's activities, behaviors, behaviors and performanalysis. Examples of AI algorithms include Classifiers, Expert systems,case based reasoning, Bayesian networks, and Behavior based AI, Neuralnetworks, Fuzzy systems, Evolutionary computation, and hybridintelligent systems. A brief description of these algorithms is providedin Wikipedia and stated below.

Classifiers are functions that can be tuned according to examples. Awide range of classifiers are available, each with its strengths andweaknesses. The most widely used classifiers are neural networks,support vector machines, k-nearest neighbor algorithms, Gaussian mixturemodels, naive Bayes classifiers, and decision trees. Expert systemsapply reasoning capabilities to reach a conclusion. An expert system canprocess large amounts of known information and provide conclusions basedon them.

A case-based reasoning system stores a set of problems and answers in anorganized data structure called cases. A case based reasoning systemupon being presented with a problem finds a case in its knowledge basethat is most closely related to the new problem and presents itssolutions as an output with suitable modifications. A behavior based AIis a modular method of building AI systems by hand. Neural networks aretrainable systems with very strong pattern recognition capabilities.

Fuzzy systems provide techniques for reasoning under uncertainty andhave been widely used in modern industrial and consumer product controlsystems. An Evolutionary Computation applies biologically inspiredconcepts such as populations, mutation and survival of the fittest togenerate increasingly better solutions to the problem. These methodsmost notably divide into evolutionary algorithms (e.g., geneticalgorithms) and swarm intelligence (e.g., ant algorithms). Hybridintelligent systems are any combinations of the above. It is understoodthat any other algorithm, AI or otherwise, may also be used. Examples ofsuitable algorithms that can be used with the embodiments of the presentinvention are disclosed in, EP 1371004 A4, EP 1367534 A2, US 20120226639and US 20120225719, all incorporated fully herein by reference.

In various embodiments, the patient monitoring device 10 has additionalfeatures. In one embodiment, the patient monitoring device 10 changescolor, via infrared LEDs, to accurately match the wearer's skin tone.This creates a seamless and more personal integration of technology intothe user's daily life. In this embodiment, there is skin contact withthe patient monitoring device 10.

In another embodiment, the patient monitoring device 10 remotely remindsand can be used to administer medications. As a non-limiting example,the patient monitoring device 10 can inject adrenalin. In oneembodiment, the patient monitoring device 10 has sleep patternrecognition based on movement and heart rate.

In various embodiments, the patient monitoring device 10 uses algorithmsto determine activity type, behavioral patterns and user habits based oncollected data.

In one embodiment, the patient monitoring device 10 uses theaccelerometer information to improve the heart rate monitor. As anon-limiting example, the patient monitoring device 10 detects movementand speed. Addition of this data improves the accuracy of the heart ratemonitor and corrects for any miscalculations in vibration, noise andskin color.

In one embodiment, velocity readouts and accelerometer data are used tomeasure when to sample heart rate. For example, if the patientmonitoring device 10 registers zero velocity readout, the user isprobably at rest or engaged in a passive activity. Thus, the patientmonitoring device 10 knows not to sample heart rate. This results inconversation of time, energy and data storage.

User activity, performance and action can be based on the accelerationand angular velocity of the patient monitoring device 10. In oneembodiment, the patient monitoring device 10 has a feature where thepatient monitoring device 10 authorizes third party interaction based onhand gesture, on previous interactions or patterns of behavior. As anon-limiting example, if one purchases a coke every day for the last twoweeks, the patient monitoring device 10 can “orders” the person anotherone based on the prior history.

In one embodiment, the patient monitoring device 10 features near-bypatient monitoring device 10 recognition that provides for other patientmonitoring device 10 devices to be recognized within a particularvicinity and are able to share and transfer data between them. Thepatient monitoring device 10's data analysis and feedback can be basedon current or previous sensor output. The patient monitoring device 10can alert the user when to charge the patient monitoring device 10 andwhen it is the most convenient for the user.

In one embodiment, the patient monitoring device 10 provides feedbackvia color change. An outer shell of the patient monitoring device 10 canuse visual feedback, including but not limited to pigment or colorchanges to indicate changes in user behavior or to prompt changes inuser behavior. In one embodiment, the patient monitoring device 10 isflexible in shape. As a non-limiting example, if the user puts thepatient monitoring device 10 over their hand it can expand or contract,morphing to change size and shape.

In one embodiment, the patient monitoring device 10 can have a syncfeature for multiple bands at the same time.

In one embodiment, the patient monitoring device 10 has data transfer toan external device that can be included or not included in system 32.Patient monitoring device 10 could be a data leaching device. Forexample, the user can relay information to someone else's device(intermediary device) to access Network Systems connected device.

In one embodiment, the patient monitoring device 10 can disable therecording of one or more sensors 14 based on location, acceleration (orlack thereof) and the like.

In one embodiment, the patient monitoring device 10 detects differenttypes of transportation and activity based on sensor data. In oneembodiment, patient monitoring device 10 can unlock doors or cars. Theuser can turn it on and off. As a non-limiting example, it can be turnedoff by having a capacitor switch on top and bottom and is placed in away that one couldn't accidentally turn it off. As a non-limitingexample, turning it off can be done by rotating the patient monitoringdevice 10 once.

In one embodiment, the patient monitoring device 10 recognizes thewearer based on biometric information, previous data, movement pattern,and the like. In one embodiment, the patient monitoring device 10detects a new user based on an inability to match to user/usagepatterns.

As non-limiting examples, a variety of different sensors 14 can be usedsuch as, an altimeter, blood oxygen recognition, heart rate from wristvia sonar, Doppler, based on sound wave and movement, based on pressure,and the like. A pressure sensor 14 can be placed on a circulatory vesselsuch as a vein to detect pulse.

With the patient monitoring device 10 of the present invention,mechanical actions of the user can be triggered, recognized andevaluated.

As a non-limiting example, with multiple users and wearable devices 10,a separate patient monitoring device 10 ID is assigned to each of theusers A, B AND C, and thereafter the assigned transmitter/monitor 14generates user activity data and/or user tracking data. For purposes ofthis disclosure, monitoring data is defined to include data acquiredduring the process of monitoring or evaluating a predefinedcharacteristic. The user activity data tracks data from the sensors 14is transferred to the receivers 34 via the wireless connections 38represented by a dashed line.

A network of receivers 34 transfers the user activity and/or trackingdata to system server 16 via connection 50. System server 16 includes aprocessor 52 configured to process the user data in a known manner. Forexample, the processor 52 may convert raw user data acquired by thesensors 14 into more conveniently readable data.

As a non-limiting example, the display 42 can be implemented tographically convey user information from system server 16 in aconveniently readable manner. As a non-limiting example, the user may bea cardiac patient with user monitoring data graphically conveyed as aconventional ECG plot comprising a sequence of P-waves, a QRS complexesand a T-waves. As another example, user tracking data may be graphicallyconveyed as an icon superimposed onto a map to indicate the user'srelative location. Alarm 44 may be included in this embodiment.

In some embodiments, system 32 ID circuitry delivers a unique ID to thewearable device from database 18. BLUETOOTH® chips can be coupled withother wearable devices 10 in the area. This data is then stored, as morefully explained in the following paragraph. The unique ID can beutilized for a variety of different applications including but notlimited to payments, social networking and the like.

The ID circuitry of system 32 can include a number of system/components:unique ID storage, communication system, which reads and transmits theunique ID from the unique ID storage, battery 24 or power system thatprovides power to enable communication with the patient monitoringdevice 10, a pathway system to route signals to through the circuitry, acluster that crunches information, and a control system, to orchestratethe communication between different systems. All of these systems can beimplemented in hardware, software or a combination thereof. Continuingwith the telemetry system 32, sensors 14 and sensing devices aredisposed on wearable devices 10 worn by users. Data, such as movement,location, speed, acceleration, and the like, can be acquired, capturedand provided to system 32.

System 32 and an associated network can include an identificationreference, including user activity, performance and referenceinformation for each individual sensor 14 and location.

The user activity, performance metrics, data and the like captured bysystem 32 can be recorded into standard relational databases SQL server,and/or other formats and can be exported in real-time.

In various embodiments, the patient monitoring device 10 and/or system32 are fully sealed and have inductively charges. All communication isdone wirelessly.

In one embodiment, there are no electrical contacts, physical contactsor connections with the patient monitoring device 10. The patientmonitoring device 10 is seamless. The telemetry system 32 can include amicroprocessor with CPU 20, memory, interface electronics andconditioning electronics 33 configured to receive a signal from thesensors 14. In one embodiment, all or a portion of the conditioningelectronics 33 are at the patient monitoring device 10.

In one embodiment, the CPU 20 includes a processor 52, which can be amicroprocessor, read only memory used to store instructions that theprocessor may fetch in executing its program, a random access memory(RAM) used by the processor 52 to store information and a master dock.The microprocessor is controlled by the master clock that provides amaster timing signal used to sequence the microprocessor 52 through itsinternal states in its execution of each processed instruction. In oneembodiment, the microprocessor 52, and especially the CPU 20, is a lowpower device, such as CMOS, as is the necessary logic used to implementthe processor design. The telemetry system 32 can store informationabout the user's activity in memory.

This memory may be external to the CPU 20 but can reside in the RAM. Thememory may be nonvolatile such as battery backed RAM or electricallyerasable programmable read only memory (EEPROM). Signals from thesensors 14 can be in communication with conditioning electronics 33 thatwith a filter 35, with scale and can determine the presence of certainconditions. This conditioning essentially cleans the signal up forprocessing by CPU 20 and in some cases preprocesses the information.These signals are then passed to interface electronics, which convertsthe analog voltage or currents to binary ones and zeroes understood bythe CPU 20. The telemetry system 32 can also provide for intelligence inthe signal processing, such as achieved by the CPU 20 in evaluatinghistorical data.

In one embodiment, the actions of the user wearing the patientmonitoring device 10 with the unique ID can be used for differentactivities and can have different classifications at system 32.

The classification can be in response to the user's location, where theuser spends it time, with which the user spends its time, determinationof working relationships, family relationships, social relationships,and the like. These last few determinations can be based on the time ofday, the types of interactions, comparisons of the amount of time withothers, the time of day, a frequency of contact with others, the type ofcontact with others, the location and type of place where the user isat, and the like. These results are stored in database 18.

In one embodiment, the user wearing the patient monitoring device 10 canaccess this information from any place where data is presented to theuser, including but not limited to mobile devices, the WEB, applicationsprogram identifiers, and the like.

As a non-limiting example, the patient monitoring device 10 communicateswith a base station at system 32. The patient monitoring device 10 canintelligently switch between data transfer and charging based on sensorreadout. The patient monitoring device 10 can represent data based onconnected devices.

In one embodiment, the patient monitoring device 10 has the capabilityof providing recommendations, popularity of locations or activitiesbased on acquired data from the user.

In one embodiment, the patient monitoring device 10 has the capabilityof introducing the user to other people or users based on their data andthe user's data.

In one embodiment, the patient monitoring device 10 can determineemotion of the user.

In one embodiment, the patient monitoring device 10 uses incrementaldata transfer via BLUETOOTH® and the like. The patient monitoring device10 can transmit data through the inductive coupling for wirelesscharging. The user is also able to change the frequency of datatransmission.

The patient monitoring device 10 can engage in intelligent switchingbetween incremental and full syncing of data based on availablecommunication routes. As a non-limiting example, this can be viacellular networks, WiFi, BLUETOOTH® and the like. In one embodiment, thepatient monitoring device 10 has data storage. As a non-limitingexample, storage of telemetry data on patient monitoring device 10 canbe amounts up to about 16 mg.

In one embodiment, data transferred if it's in a selected proximity of abase station of system 32 or in proximity of an associated connectednetwork. In one embodiment, the patient monitoring device 10 has adynamic change of data capture frequency. The patient monitoring device10 can be programmed to instantly change how often it samples any sensor14 based upon the sensor data. Intelligent data sampling is based onsensor readout.

The patient monitoring device 10 can receive firmware updates via a basestation 110 of system 32. In one embodiment, the patient monitoringdevice 10 presents analyzed data and feedback on a website. In oneembodiment, the patient monitoring device 10's software is based onunique human movement. The patient monitoring device 10 is able toidentify its wearer based on the unique patterns of movement, locationcheck-ins and daily habits of the user.

In one embodiment, the app can be used on a mobile device, including butnot limited to a smart phone and the like.

In one embodiment, a breakdown of recounting data that has beencollecting is presented for analysis of that data. Observation orrecommendations can be presented based on historical information andlive information. The importance of the data can be based on past userbehavior.

In one embodiment, the patient monitoring device 10 has artificialintelligence. A wearable device processor 54 implements logic resourcesthat exist on patient monitoring device 10.

In one embodiment, patient monitoring device 10 engages in the routingof user information to third parties based on predefined rules, based onsystem 32 analysis.

In one embodiment, patient monitoring device 10 includes one or moreprocessors 54 that implement intelligent algorithmic processing andtransfer of information to third parties. Feedback can be provided tothe end user that is based on visual, tactile, gesture information andthe like.

The ID can be sent from the patient monitoring device 10 in a variety ofdifferent transmit modes, which may be provided as part of the firmwareor software of an ID or sensor transmitter 14, and which may be utilizedselectively during the operation of said sensor transmitter 14, mayinclude “burst” transmit modes, wherein a burst of data information istransmitted, or “parcel” transmit modes, wherein timed data packets ofdata, which may, as desired, comprise partial data strings, aretransmitted, and, if desired, repeated during time intervals. Further,the sensors 14 may have programmed therein diagnostic routines or othertest modes which assist during manufacture and use, providing theoperator with operational status and verification information on saidsensor/transmitter 14, as needed. Referring to FIG. 4, system 32includes data base 18 which contains the desired transmitter, sensor, 14personality data, as well as, the address/device ID bits for eachpatient monitoring device 10.

In one embodiment, the initial programming of the patient monitoringdevice 10 for the ID, as well as optionally other personal informationof the user, is done securely, as unauthorized future alteration of samethereafter can be utilized as a means of violating system integrity.

In one embodiment, an inductive field coil is used for programming thesensors 14 and ID of patient monitoring device 10.

As illustrated in FIG. 4, the patient monitoring device 10 can include asensor 14 with an output that be received by an amplifier 56 and decodedby an I/O decoder 58 to determine I/O logic levels, as well as, bothclock and data information 60. Many such methods are commonly availableincluding ratio encoding, Manchester encoding, Non-Return to Zero (NRZ)encoding, or the like; alternatively, a UART type approach can be used.Once so converted, clock and data signals containing the informationbits are passed to a memory 62. Any of these connections provides alogical link from the system's database 18 to the sensor 14, ID of thepatient monitoring device 10, as shown in FIG. 5.

In one embodiment, illustrated in FIG. 5, the system 32 chooses thenecessary programmable sensor functions and stores them into database18. In one embodiment, in order to insure that an unauthorized usercannot connect into and program patient monitoring device 10 thefollowing procedure may be used:

Both the sensor 14 and receiver 34 contain an identical, repeatablepseudo randomization algorithm in ROM or in ASIC logic.

Referring to FIG. 6, the algorithm is applied to outgoing programmingdata 64 from system 32 and produces a number of security/randomizationbits 66 that can be appended to the outgoing programming message ormessage 68 and sent to a sensor 14.

Referring to FIG. 7 the sensor 14 likewise applies this pseudorandomization algorithm as the security/randomization bits 66 to theoutgoing programming data, now forming the incoming programming data 70to sensor 14 and produces a several bit result in the shift register 71.The scrambling algorithm is devised such that a small difference in theprogramming bit stream causes a great difference in the pseudorandomization result. As a non-limiting example, the present inventioncan use a 16 bit polynomial to produce this pseudo randomization.

Optionally, in one embodiment, before a sensor 14 accepts thisprogramming, stored in an address and personality register 73, both thepseudo random code, stored in data in a shift register 75 from system 32and a sensor 14, in a shift register 71 must match via a comparator ID,77, indicating unauthorized acceptance use. In addition to insuringauthorized access, this process also insures that the data itself iscorrect. The longer the polynomial sequence used, the greater thesecurity.

In one embodiment, spread spectrum or other RF transmission is used andcan include programming to determine that the frequency or spreadspectrum code is unique to the area. If a spread spectrum code, systemcode, or frequency channel is found to be occupied at a future time ofuse. Re-programming of the patient monitoring device 10 is then donewith a new, unused spread spectrum code or system code or frequencychannel can be selected, or, in the alternative, CPU 20.

As illustrated in FIG. 5, step “E” would include, for example, the stepof the sensor 14, inputting the programming message and saving a seed inmemory 62; with the sensor 14 utilizing the seed to code digital databits transmitted.

As illustrated in FIG. 8, the location of a patient monitoring device 10with the ID and sensors 14 can be determined. As a non-limiting example,in one embodiment the patient monitoring device 10 includes a sensor 14that can provide a position signal having positioning data (e.g., rawGPD data or pseudo ranges) and the ID is transmitted from the patientmonitoring device 10 to system server 16. Server 16 receives theposition signal and analyzes the signal to generate informationrepresenting the location of the patient monitoring device 10. Server 16transmits this location information to a client computer where thelocation of the patient monitoring device 10, allowing a user toidentify the location of the remote sensor 14.

In one embodiment, the position signal transmitted by the remote sensor14 can also include an emergency code. For example, in the event of anemergency, such as a medical emergency or otherwise, a user may press a“panic button” that can be on the patient monitoring device 10 or by useof a user's mobile device. Pressing the panic button may cause mobiledevice 74 to transmit an emergency signal to a cell site 76 where theemergency signal is relayed to server 16. In response, server 16 cantransmit Doppler information regarding in-view satellites, a fix commandand a time trigger signal to the patient monitoring device 10.

When the location of the patient monitoring device 10 has beendetermined, software running on server 16 configures server 16 such thata call or other signal is sent to a local emergency operator in thevicinity of remote sensor 14. When the call or signal is received at theemergency operator station, the location of remote sensor 14 istransmitted and displayed. In some cases, where separate panic buttonsare available for identifying medical, police, fire or other types ofemergencies, the nature of the emergency is also displayed for theemergency operator. Based on this information, the emergency operatorcan initiate an emergency response by providing the location of remotesensor 14 to the required emergency service (police, fire department,ambulance service, etc.). In other embodiments, instead of or inaddition to a position report for the remote sensor 14, the emergencyoperator may also be provided with information which identifies anemergency response vehicle in close proximity to remote sensor 14.

As illustrated in FIG. 9, a sensor 14 of the patient monitoring device10 can include a SNAPSHOT GPS receiver 72. As described above, sensor 14uses information transmitted from separately located base station 110,mobile devices, computers, and other devices, to assist in determiningthe position of the remote sensor 14, as more fully disclosed in U.S.Pat. No. 6,661,372, incorporated herein by reference.

As non-limiting examples, and as illustrated in FIG. 10, the sensors 14can be a thermal transducer 78, an acoustic transducer 80, and amagnetic transducer 82. It will be appreciated that the presentinvention is not limited The transducers 78, 80, and 82 in the patientmonitoring device 10 can communicate with a microprocessor 84 alsolocated in the patient monitoring device 10. The patient monitoringdevice 10 can communicate with other devices via an RF transceiver 86,an IRDA transceiver 88, and/or an RF backscatter transceiver 90. Each ofthe components in the patient monitoring device 10 receives power asnecessary from the battery 24, which may include the rechargeablebattery.

The acoustic transducer 80 may include a microphone, a low-pass filter,a gain amplifier, and a threshold comparator. The acoustic transducer 80may include an omnidirectional microphone, although any other suitableacoustic transducer device would suffice. The microphone may be asurface mount MEMS device that has a frequency range of 100 Hz to 10kHz. A single MCP602 operational amplifier is used on the acousticsensor to amplify and low-pass filter the acoustic signal from themicrophone. Another operational amplifier is used to generate a voltagereference used for single biasing and detection. The microphone outputis biased to the midway point between the circuit supply voltage andground to allow for both positive and negative signal swings. The biasedsignal is filtered with a second order low-pass Butterworth filter toremove upper frequency noise. It is then amplified with an adjustablegain that is controlled by a digital resistor potentiometer. Thisdigital resistor operates on an I2C bus and is controlled by themicroprocessor 84. Lastly, the amplified acoustic signal is thresholddetected against a static voltage to detect sufficiently large acousticsignals. The digital output of the threshold detector is connected tothe microprocessor 84 for processing.

The magnetic transducer 82 can include a magnetic sensor integratedcircuit, a differential instrumentation amplifier, a low-pass filter,two gain amplifiers, and a threshold detector. The magnetic transducer82 may include an NVE AA002-02 GMR (giant magneto resistive) fieldsensor, although any suitable magnetic sensor would suffice. This sensorhas a saturation field of 15 Oe, a linear range of 0 to 10.5 Oe, and asensitivity of 3 mV/V/Oe. Two MCP602 CMOS operational amplifiers areused on the magnetic sensor to amplify and low-pass filter the analogoutput signal. An INA122UA instrumentation amplifier is used as adifference amplifier for the differential output from the magneticsensor. The magnetic sensor IC can be based on Spintronics technology.Its output includes a differential voltage pair proportional to thedetected magnetic field. The differential voltage pair is amplified andconverted to a single voltage by the instrumentation amplifier. TheAC-coupled signal is then amplified and filtered with a low-pass filterto remove upper frequency noise and boost the low-voltage signal output.The signal is amplified a second time by an adjustable gain controlledby a digital resistor similar to the acoustic sensor. Lastly, theamplified magnetic signal is threshold detected against a staticvoltage, to detect sufficiently large changes in magnetic fields. Thedigital output of the threshold detector can be connected to themicroprocessor 84 for processing.

A DS1803E-010 digitally controlled 10 kOhm variable resistor can be usedin both the acoustic and magnetic sensor circuits. It is used to adjustthe gain of one gain stage in each circuit. The digital resistor iscontrolled through an I2C interface. A LMV3931PWR comparator is alsoused in both the magnetic and acoustic sensor circuits for determiningwhen a sufficiently strong sensor signal has been detected. It comparesthe analog sensor signal against the voltage reference and its output istied to the microprocessor 84 for data collection.

The thermal transducer 78 may include a Burr Brown TMP 100NA/250 12-bitdigital temperature sensor, although any suitable thermal sensor wouldsuffice. The digital temperature sensor has an operating range of −55 to+120.degree. C., an accuracy of 0.5.degree. C. and a maximum resolutionof 0.0625.degree. C.

Even though it is a 12-bit sensor, suitable results are achieved withonly 9-bit conversions with only the 8 most significant bits used. Thesensor has an I2C interface and is normally kept in sleep mode for lowpower operation. When directed by the microprocessor 84, the thermaltransducer can perform a 9-bit temperature conversion in 75milliseconds.

The RF transceiver 86 may include an RF Monolithic DR3000 transceiver,although any suitable transceiver or separate transmitter and receiver34 would suffice. This transceiver 86 allows for both digitaltransmission and reception. The transceiver 86 can have an operatingfrequency of 916.5 MHz and is capable of baud rates between 2.4 kbps and19.2 kbps. It can use OOK modulation and has an output power of 0.75 mW.It also can use digital inputs and outputs for direct connection withthe microprocessor 84. The transceiver 86 can use an antenna 92 (FIG.11) that may include a 17 mil thick plain steel electric guitar G-stringcut to a length of 8.18 cm. It is used in a monopole over groundconfiguration and can require a matching circuit of one inductor and onecapacitor. Alternatively, Frequency Shift Keying (FSK), Quadrature PhaseShift Keying (QPSK), or any other suitable modulation scheme may beutilized.

The IRDA transceiver 88 may include a Sharp GP2W0110YPS infraredtransceiver, although any suitable IRDA compliant infrared transceiverwould suffice. This transceiver 88 can be IRDA v1.2 compliant and in oneembodiment has an operating range of 0.7 meters. In one embodiment, itis capable of 115.2 kbps data speeds.

The RF backscatter transmission device 90 may include circuitryavailable from Alien Technology (of Morgan Hill, Calif.) for receivingand transmitting signals via RF backscatter. Battery 24 may be a 3.6volt ½ AA lithium battery with a capacity of 1.2 amp hours. The battery24 can be a power source 24 that can include a Texas InstrumentsTPS76930 DBVT voltage regulator to regulate the output signal to 3 voltsand with a maximum current of 100 mA. The voltage regulator can includea LDO.

The RF backscatter transceiver 86 in the patient monitoring device 10communicates with an RF backscatter reader 94 such as a class 3 readerfrom Alien Technology. The reader 94 transmits data to the backscattertransceiver 90 of the patient monitoring device 10 by broadcastingencoded RF pulses and receives data back from the transceiver 86 bycontinually broadcasting RF energy to the sensor 10 and monitoring themodulated RF reflections from the sensor 10.

The RF backscatter transceiver 90 can include a printed circuit board(PCB) patch antenna for RF reception, and RF modulation, a Schotky diodedetector circuit, a comparator circuit for signal decoding, and a logiccircuit for wake-up. The logic circuit monitors the incoming data, andwhen an appropriate wake-up pattern is detected, it triggers themicroprocessor 84 so that data reception can begin. In one embodiment,the reader 94 has an operating frequency between 2402 MHz and 2480 MHz,and uses frequency hopping in this band to reduce noise interference. Amodulation method used by the reader 94 can be On-Off Keying (OOK). Inone embodiment, the transmission power is 1 watt. The operation of thereader 94 may be controlled by an external computer (not shown) asdirected by Labview software via a RS-232 serial link.

The RF transceiver 86 can communicate with an external RF transceiver 96such as a DR3000 transceiver from Radio Monolithics, Inc. In oneembodiment, it operates at 916.5 MHz, uses OOK modulation, has acommunication range of 100 meters line of sight, and a baud rate of 19.2kbps. The active RF antenna 92 can be a quarter-wavelength monopole madefrom a guitar G-string and appropriate matching circuitry. Two controllines from the microprocessor 84 can be used to select the mode ofoperation, choosing from transmit, receive, and sleep. The active RFreceiver 34 consumes the most power in receive mode compared to theother two communication links.

FIG. 6 shows the relative positioning and shape of the active RF antenna92 and the RF backscatter antenna 98.

The IRDA transceiver 88 of the patient monitoring device 10 cancommunicate with an external IRDA transceiver 100 that may be identicalto the IRDA transceiver 88. Alternatively, the IRDA transceiver 100 canbe one such as is provided in most personal digital assistants (PDA) aswell as many other consumer devices. The IRDA communication link followsthe standard IRDA signal and coding protocol and is modeled after astandard UART interface. In one embodiment, the IRDA transceiver 88 iscapable of data speeds less than 115.2 kbps, and may only have a rangeof 0.7 meters for transmission. One advantage of the IRDA communicationlink is that it does not require any of the RF spectrums for operation,but it typically does require line-of-sight communication.

When any one of the transceivers 86, 88 and 90 on the patient monitoringdevice 10 detect the beginning of valid data on their respectivecommunication link, all other transceivers are disabled, therebypreventing the corruption of incoming data with the noise or partialdata packets on the other communication links. However, if the data onthe active transceiver proves to be erroneous, the other transceiverswill be re-enabled if appropriate to allow normal operation to continue.If the data received by the active transceiver is valid, however, theother transceivers will remain disabled for several hundred millisecondslonger in the high probability that the next data packet will betransmitted on the same communication link. If, after this extendeddelay, no additional packets are received, then the other transceiverswill be re-enabled as appropriate.

In one embodiment, the active RF protocol has no wake-up orsynchronization packets, and the packets sent to and from the sensor areidentical. In one embodiment, the format of an active RF packet is shownin FIG. 2. It can include a preamble to reset and spin-up the statemachine of the RF receiver 34 and to properly bias the receiver's 34data slicer/threshold detector for optimum noise rejection and signalregeneration, two framing bits to indicate the beginning and end of thedata bytes, and the data bytes themselves.

Furthermore, the encoding scheme for the three symbols is shown in FIG.12. The entire packet is DC balanced to maintain an optimal level on thedata slicer/threshold detector and the receiver 34. Data is sent mostsignificant bit first.

The IRDA communication link can follow the standard IRDA protocol forbit encoding and UART protocol for byte transmission. Packetstransmitted on the IRDA link can contain no preamble or framing bits,but they do have a header that contains two bytes. The first byte is anASCII “I” which denotes the beginning of a valid IRDA packet. The secondbyte equals the number of preceding bytes in the packet. This value isused by the receiver 34 to determine when the entire packet has beenreceived and processing of information can begin. The packet structureis shown in FIG. 13 and the IRDA/UART encoding scheme is shown in FIG.14.

The data bytes contained in a packet transmitted to the sensor 10through any of the communication links conform to a packet format. TheCMD section of a packet is a single byte that identifies the type ofpacket being sent. The CMD byte appears above the beginning and end ofthe packet and the two must be identical. The reason for including theredundant byte is to further eliminate the chance of a packet's CMDidentifier being corrupted at the receiver 34, even if the CHECKSUM iscorrect.

The PAYLOAD contains all of the data that must be sent to, or returnedfrom, the sensor. The PAYLOAD is broken down into individual bytes withthe overall number of bytes and their content dependent on the type ofpacket being sent.

The CHECKSUM is a 16-bit CRC that is performed on all bytes in the datapacket excluding the end CMD byte in packets generated by the externaldevice. The CHECKSUM is sent most significant byte first.

The transceivers 86, 88 and 90 may be required to communicate over agreater distance than do the components described herein. Upgradingthese components to be suitable for longer distance transmission isconsidered to be within the spirit of this invention. The type oftransducer is not limited to the specific transducer types describedherein. In addition, the logic described herein for arbitrating betweenwhich communication device to use to communicate with the outside worldand which sensor data to provide at what time is but one possibleapproach to arbitration logic within such a remote sensor 10.

FIG. 15 illustrates one embodiment of an exemplary network 101 that canbe used with the present invention. As shown in FIG. 15 a wirelesspacket data service network 102 that can be utilized with the patientmonitoring device 10. An enterprise network 104, which may be apacket-switched network, can include one or more geographic sites and beorganized as a local area network (LAN), wide area network (WAN) ormetropolitan area network (MAN), and the like. One or more applicationservers 106-1 through 106-N can be included and disposed as part of theenterprise network 104 are operable to provide or effectuate a host ofinternal and external services such as email, video mail, NetworkSystems access, corporate data access, messaging, calendaring andscheduling, information management, and the like using the unique IDs ofthe wearable devices 10. The patient monitoring device 10 can be incommunication with a variety of personal information devices other thanthe patient monitoring device 10, including but not limited to,computers, laptop computers, mobile devices, and the like.

Additionally, system server 16 may be interfaced with the enterprisenetwork 104 to access or effectuate any of the services from a remotelocation using a patient monitoring device 10. A secure communicationlink with end-to-end encryption may be established that is mediatedthrough an external IP network, i.e., a public packet-switched networksuch as Network Systems 108, as well as the wireless packet data servicenetwork 102 operable with a patient monitoring device 10 via suitablewireless network infrastructure that includes a base station (BS) 110.In one embodiment, a trusted relay network 112 may be disposed betweenNetwork Systems 108 and the infrastructure of wireless packet dataservice network 102.

In another embodiment, the infrastructure of the trusted relay network112 may be integrated with the wireless packet data service network 102,and the functionality of the relay infrastructure can be consolidated asa separate layer within a “one-network” environment. Additionally, asnon-limiting examples, patient monitoring device 10 may be capable ofreceiving and sending messages, web browsing, interfacing with corporateapplication servers, and the like, regardless of the relationshipbetween the networks 102 and 112. Accordingly, a “network node” mayinclude both relay functionality and wireless network infrastructurefunctionality in some exemplary implementations.

In one embodiment, the wireless packet data service network 102 isimplemented in any known or heretofore unknown communicationstechnologies and network protocols, as long as a packet-switched dataservice is available therein for transmitting packetized information.For instance, the wireless packet data service network 102 may becomprised of a General Packet Radio Service (GPRS) network that providesa packet radio access for mobile devices using the cellularinfrastructure of a Global System for Mobile Communications (GSM)-basedcarrier network. In other implementations, the wireless packet dataservice network 102 may comprise an Enhanced Data Rates for GSMEvolution (EDGE) network, an Integrated Digital Enhanced Network (IDEN),a Code Division Multiple Access (CDMA) network, a Universal MobileTelecommunications System (UMTS) network, or any 3rd Generation (3G)network.

Referring now to FIGS. 16( a) through 16(d), in one embodiment, thepatient monitoring device 10 is in communication with an interactionengine 120 that can be at a mobile device 74 or system 32. The interfaceengine can be a software application running on mobile device 74associated with another party, including but not limited to a merchant,an associate, a friend, and the like. The enables the patient monitoringdevice 10 user and a merchant to interact with a transaction engine 114to and enter into a financial transaction for the transfer of funds froma third party payment system 116 that is independent of the patientmonitoring device 10 user's financial account 118, and complete atransaction. It should be noted that the payment system 116 can beaffiliated with the financial account 118 or can be a separate andnon-affiliated with the financial account 118. The interaction engine120 can take input of information related to a transfer of funds fromthe patient monitoring device 10 users' financial accounts 118 as inputto the transaction engine 114 to initiate and complete a financialtransaction, including but not limited the purchase and payment of goodsand services.

In one embodiment, this input to the interaction engine 114 can include,an amount of a transaction, additional items related to the transaction,authorization and/or signature of the patient monitoring device 10 user.

In one embodiment, the mobile device 74 receives information from thepatient monitoring device 10, e.g., the unique ID.

The interaction engine 120 can also present products or servicesprovided by a merchant to directly to or through system 32 to thepatient monitoring device 10 user.

In one embodiment, the patient monitoring device 10 users can use themobile device 74, the WEB, and the like, to view, text, pictures, audio,and videos, and browse through the products and services on the mobiledevice 74, personal computers, other communication devices, the WEB, andanything that is BLUETOOTH®, anything associated with Network Systems,and the like.

In one embodiment, the transaction engine 114, which can be at themobile device 74, or external to the mobile device 74, including but notlimited to patient monitoring device 10 and the like, takes decodedfinancial transaction card information from a decoding engine 122,internal or external to the mobile device 74, and a transaction amountfrom an interaction engine 120, also internal or external to the mobiledevice. The transaction engine 114 then contacts the payment service116, and or the patient monitoring device 10 users' financial account118, such as an acquiring bank that handles such authorization request,directly or through the payment system 116, which may then communicatewith a financial transaction card issuing bank to either authorize ordeny the transaction. The payment system 116 can include a userdatabase, a transaction database, a product database, and the like.These databases can also be external to payment system 116. If the thirdparty authorizes the transaction, then the transaction engine 114transfers funds deducted from the account of the patient monitoringdevice 10 user, or the payment system 116 can already have those fundsreadily available, to an account of a third party which can be anotherpatient monitoring device 10 user, a merchant, and the like, andprovides transaction or transfer of fund results to the interactionengine 120 for presentation to a third party.

In one embodiment, the transaction engine 114 does not have thefinancial account or financial card information of the patientmonitoring device 10 user that is doing the transfer. In someembodiments, the transaction engine 114 keeps only selected informationof the patient monitoring device 10 user's financial accounts 118 orfinancial transaction cards.

In one embodiment, the wearable device communicates directly, withoutmobile device 74, with the payment system 116 and/or the user'sfinancial account 118 or associated financial institution.

In one embodiment, the transaction engine 114 communicates and interactswith the financial account 118 or associated financial institutiondirectly or through the payment system 116, through a user database,product database, and transaction database, which databases can beseparate from or included in the payment system 116, over a network. Thenetwork can be a communication network, as recited above, and can bebased on well-known communication protocols, including but not limitedto, a TCP/IP protocol.

With social networking applications, the patient monitoring device 10,with its unique ID, is an ID device. Information from the patientmonitoring device 10 relating to social networking, and the like,communicates with system 32. In this manner, the wearable devices 10,with their own unique ID's, can be recognized. This can occur atdifferent locations, close by, distanced, and notifications can be sentto the different users wearing a patient monitoring device 10 for avariety of social networking and other communication applications.Additionally, patient monitoring device 10, with its sensors 14 and IDcan communicate directly to social networking sites, Network Systems,cloud services, and the like.

In one embodiment, with the current permissions given by the wearabledevice users, marketers, companies or individuals who wish can deliveradvertisement patient monitoring device 10 users. More particularly,system 32 can be configured to allow marketers, and the like, to deliveradvertisements to consumers to buy products or services offered by themarketer. Advertisements can also be sent to patient monitoring device10 users with the appropriate permissions. In one embodiment, system 32maintains the anonymity of the patient monitoring device 10 users whileallowing the marketers to have their advertisements delivered to thosethat fall within their defined market segment.

In one embodiment, the wearable device ID of a user provides a method ofidentifying and contacting users of a social networking service. Themethod may include the steps of signing up for a social networkingservice, displaying the wearable device ID, viewing another person'sunique wearable device ID displayed by another user, and finding thatuser on a social networking service website by searching for the userusing the wearable device ID viewed.

System 32 may serve a number of purposes without straying from the scopeof the present invention. For example, the social networking service mayallow patient monitoring device 10 users to engage in non-romanticrelationships, keep in touch with acquaintances, friends and family,professional business relationships, and romantic relationships, mayallow communication between wearable device users on a message board orNetwork Systems forum, and may allow users to follow up onmissed-connections that otherwise would not have been realized.

In one embodiment, the step of providing personal information to startan account with system 10 for different applications may be performed bya purchasing or acquiring a patient monitoring device 10, with a uniqueassigned ID, and the user can fill in an online form. This form mayrequire users to fill in fields on the form. These fields may include:first and last name, email address, a desired password, phone number,gender, birth date, address, geographic region, education information,employment information, interests, relationship information andinterests, family information, religious views, ethnicity, physicalfeatures including hair color, eye color, measurements, and the like,type of relationship being sought, living situation, answers to quizquestions, and a personal description about interesting personalitytraits, among other things. In addition, users may upload one or aplurality of photographs for other users to view, or for users to storethe photo or photos on the server of system 32.

In another embodiment the step of providing personal information tostart an account with system 32 by patient monitoring device 10 usersmay be performed automatically. In this embodiment, system 32 can accessa social networking service, access, via computer, contact lists orother sources of information that may include the type of informationlisted above.

In a further embodiment, the step of providing personal information tosystem 32 can be automated by importing data containing the personalinformation required from other social networking services including butnot limited to Facebook®, LinkedIn®, MySpace®, Match.com®,EHarmony.com®, a user's email or contact list, v-card, and the like.

The unique wearable device ID may allow the user to be searched andidentified by other users and potential users. Also, a computergenerated email address may be provided to a user. In one embodiment,this email address may be the user's user ID followed by “@iseenya.com.”In another embodiment, the email address may be the user's user IDdirected to another domain name.

In one embodiment, a computer generated personal page may be provided toa patient monitoring device 10 user. The personal page may utilize acomputer to automatically import the information provided when signingup with system 32 or a social networking service. In another embodiment,the information and formatting of the personal page can be customizable.

When mobile device 74 is used, it communicates with one or more sensors14 that are at the patient monitoring device 10, as more fully herein.The mobile device can 74 pull from system 32 updates from the server 16,including but not limited to settings such as alarms, name of thewearable device wearer using the ID, a sensor 14 and the like. Sensors14 at the patient monitoring device 10 can send streams of information,both encrypted and non-encrypted to the mobile device and then to theserver at system 32. Server 16 sends encrypted, and can also sendnon-encrypted information, to mobile device 74. Processing of thisinformation can be achieved at the mobile device 74, and/or server 16.Mobile device 74 can receive raw sensor information from the patientmonitoring device 10. This information can be compressed as well asnon-compressed. A compression algorithm, at the wearable device and/ormobile device 74 or system 32, can be used in order to minimize theamount of information that server 16 sends. System 32 can includeadditional encryption and/or decryption systems.

Referring now to FIG. 17, a social network circle/group 124 (hereinafter“SNET circle”) comprising social devices 126, including patientmonitoring device 10, is shown. Beyond traditional social networkingfeatures and services, a SNET circle 124 and associated social devices124 according to various embodiments of the invention include numerousnovel features and attributes as described more fully below with generalreference to the illustration. Patient monitoring device 10 can utilizenetwork 101 for communication with the SNET circle, as well as withother social networking sites, or through system 32.

Briefly, membership in the SNET circle 124 may comprise docked andundocked social devices 124 and human SNET circle members 128, as wellas proxies thereof. Further, SNET circle 124 nodes may include deviceservices and software (e.g., applications) of various typesparticipating as members. By way of example, SNET circle members mightinclude artificial intelligence agents/social robots 130, SNET securitydevice(s) 132, appliances, vehicles and service providers 134, common orauthorized members/functionality of other SNET circles 124, and thelike. Further, access to specific content and resources of a SNET circle124 may be shared with members of additional SNET(s) 124, includingremote or web-based applications. Such access can be conditioned onacceptable profiling and association data. Similarly, social devices orindividuals may be granted temporary or ad hoc memberships, with orwithout restricted access.

In the illustrated embodiment, formation, maintenance and operation ofSNET circle 124 is performed by standalone or distributed SNETprocessing circuitry and software 136. It is noted that the “SNETprocessing circuitry” may comprise hardware, software, applications, orvarious combinations thereof, and be configurable to support variousfunctionalities disclosed herein. Further, the SNET processing circuitry136 may be included in a standalone server, server farm, cloud-basedresources, network 101, system 32 and/or the various types of devicesdescribed below, and incorporate authentication and securityfunctionality 138. In addition, specialized middleware may also beutilized by SNETs according to the invention, including standardizedmiddleware with an associated certification process. Interactions andinterdependencies within the SNET circle 124 may involve one or more ofa social device association/control module 140, a SNET circle memberprofiling module 142, and an adaptive resource allocation andarbitration module 144 as described more fully below.

Distribution of internal and external SNET content/media 146 can beaccomplished in a variety of ways in accordance with various embodimentsof the invention. For example, media distribution may involve anadaptive or parallel network routing infrastructure involving a widevariety of communication protocols and wired and/or wirelesscommunications channels. SNET content/media 146 may comprise, forexample, various user-driven (advertising) channels, pictures, videos,links, online text, etc. Access to such content, as well ascommunications with and remote access to social devices 124 of the SNETcircle 124, may occur over an Network Systems backbone 148, cellularcommunication system, WAN, LAN, and the like.

FIG. 18 illustrates an embodiment of a social group 150 comprising avariety of members in accordance with the present invention that cancommunicate through their wearable devices 10 and other devices,including but not limited to mobile devices 74. In this embodiment,membership in the social group 150 may include a variety of novel socialsystem members 152 functioning in various capacities within the socialgroup 150. As will be understood, certain of the social system members152 may support direct or indirect associations between the social group150 and human members/non-members and users 154.

In the illustrated embodiment, social system members (or nodes) 152include one or more local or remote servers and server clusters thatprovide a support infrastructure for social group functionality andmember operations (routing, data storage, services, etc.).Communications within the social group and with non-members may occurvia dedicated or multi-function communication path devices.

Social system members 152 further include devices configured to operateas nodes within the social group 150. Social functionality in suchdevices and other social system members 152 can be implemented throughvarious means. For example, a device may have integralhardware/firmware/software to support social group access and memberoperations. Alternatively, a general purpose device 152 a may includesocial code that enables participation in the social group 150. In afurther embodiment, a device 152 b designed to include socialfunctionality may participate in the social group 150 through acombination of non-social code and a social shim layer or driverwrapper. In yet another embodiment, a member device 152 c having asocial design may utilize additional social code, including codespecific to a social group 150.

Participation in the social group 150 is supported through functionalitythat includes automated and member-triggered membership invitations andprocessing (membership management) 156. More particularly, membershipmanagement 156 may function to invite prospective members to participatein the social group 150 through automatic, automated andmember-triggered processes. For example, membership management 156 mightbe configured by a human user 154 to establish a social group 150 byautomatically inviting/accepting social system members having certaincharacteristics (such as devices owned or controlled by the user oracquaintances of the user).

Processing of accepted invitations and unsolicited requests to join thesocial group 150 may be conditioned upon input or authorization from anexisting social system member(s) 152 or human user(s) 154 (e.g., througha user interface). Similarly, membership management 156 may beconfigured to generate automated suggestions regarding which prospectivemembers receive an invitation. Various other approaches, such as thosedescribed herein, can be used to establish membership in accordance withthe invention.

Access to and visibility of resources of a social group 150, includingservices and data, may be managed through general and memberclass-specific access configurations 158. For example, if membership inthe social group 150 includes family members and associated devices, auniform access configuration (or separate device and humanconfigurations) could be applied across the class in an automatic orautomated manner. In other embodiments, access control and constraintsare imposed on a per-member basis.

The social group 150 may offer a wide variety of member services 162,including both internal and external services accessible by socialsystem members 152. By way of example, the social group 150 may offeremail or other communication services between full members and/orauthorized guest members and visitors. As with other resources of thesocial group 150, access control and constraints on member services 162may be applied to individual members or classes of members.

FIG. 19 is a functional block diagram illustrating a social network(SNET) infrastructure 164, as more fully described and disclosed in EP2582116, fully incorporated herein by reference.

In one embodiment, illustrated in FIG. 20, wearable devices 10 are incommunication with a distributed computer network 166 that can includenetworks 102, 104, 112, coupled to Network Systems 108 and system 32 viaa plurality of communication links 168. Communication network 166provides a mechanism for communication with system 16, patientmonitoring device 10, social media networks, mobile devices 74, paymentsystems, 116, the engines 114, 120, 122, components of system 16, andwith all third parties, as described above.

The communication network 166 may itself be comprised of manyinterconnected computer systems and communication links. Communicationlinks 168 may be hardwire links, optical links, satellite or otherwireless communications links, wave propagation links, or any othermechanisms for communication of information. Various communicationprotocols may be used to facilitate communication between the varioussystems shown in FIG. 20. These communication protocols may includeTCP/IP, HTTP protocols, wireless application protocol (WAP),vendor-specific protocols, customized protocols, and others.

While in one embodiment, communication network 166 is the NetworkSystems, in other embodiments, communication network 166 may be anysuitable communication network 166 including a local area network (LAN),a wide area network (WAN), a wireless network, an intranet, a privatenetwork, a public network, a switched network, and combinations ofthese, and the like.

System 32 is responsible for receiving information requests fromwearable devices 10, third parties, and the like, performing processingrequired satisfying the requests, and for forwarding the resultscorresponding to the requests backing to the requesting patientmonitoring device 10 and other systems. The processing required tosatisfy the request may be performed by server 16 or may alternativelybe delegated to other servers connected to communication network 166.

FIG. 21 shows an exemplary computer system that can be utilized with thewearable devices 10. In an embodiment, a user interfaces with system 32using a patient monitoring device 10 and then through a computerworkstation system, such as shown in FIG. 21, a mobile device, and thelike.

The communication network 166 may be the Network systems, among otherthings. The network may be a wireless, a wired network (e.g., usingcopper), telephone network, packet network, an optical network (e.g.,using optical fiber), or a wireless network, or any combination ofthese. For example, data and other information may be passed between thecomputer and components (or steps) of a system of the invention using awireless network using a protocol such as Wi-Fi (IEEE standards 802.11,802.11a, 802.11b, 802.11e, 802.11g, 802.11i, 802.11n, and 802.11ac, justto name a few examples), near field communication (NFC), radio-frequencyidentification (RFID), mobile or cellular wireless (e.g., 2G, 3G, 4G,3GPP LTE, WiMAX, LTE, Flash-OFDM, HIPERMAN, iBurst, EDGE Evolution,UMTS, UMTS-TDD, IxRDD, and EV-DO). For example, signals from a computermay be transferred, at least in part, wirelessly to components or othercomputers.

FIG. 22 shows a system for activity collection and building a socialgraph for network patient monitoring device 10 users. The systemmonitors users as they surf the Web, their activities, locations,status, interests, and other things, This can be achieved without regardto whether the wearable device users 10 are logged into a membershipsite, such as a social networking site.

Resources 170 and 172 gather activity data and pass this data to anactivity storage server 174, typically via Network Systems 108. Partnerresource 172 may be processed by a partner back end, and then this datais passed to activity storage server 174.

Patient monitoring device 10 users can use social media sharingapplication or sites. Applications (e.g., a mobile device app or sitesallow sharing of information with others. These can be used to collectactivity data. A patient monitoring device 10 user (sender) can shareinformation (e.g., video, photo, link, article, or other) by posting toa site. The patient monitoring device 10 user can post directly on thesite or use an application program, such as a mobile application on asmartphone or tablet computer. When another user (recipient) clicks orvies the link, there is connection activity between the sender andrecipient. This activity data is captured by system 32.

Messenger applications such as those on mobile device 74 or sites canallow Network Systems or Web messaging with others. Network Systemsmessaging is different from short messaging server (SMS) or textmessaging. Messenger applications can be used to collect sharingactivity data.

Users use messenger application to send links and other information toother users, and also achieve this using their wearable devices 10. Auser (sender) can copy a link (e.g., via a clipboard) and send to one ormore users via the messenger application with mobile device 74 and withits patient monitoring device 10. When a recipient user clicks on thelink, there is connection activity between the sender and recipient forthat link.

Sharing activity data can be captured as described above. There can bedifferent data collectors for different devices and platforms. Theactivity data is transmitted to and stored at activity storage server174, typically through Network Systems. Server 174 stores the data forfurther processing. There can be a significant amount of real-time datathat is collected for processing. Distributed computing and processingcan be used to process the data.

The activity data collected is stored at server 174, usually in adatabase or file systems on hard drives of server 174. There may be manyterabytes of data that need are to be processed. Taking the storedactivity data as input is a build-update graph component (e.g.,executable code running on one or more servers or other computers).Build-update graph component 178 can run on the same server that storesthe activity data, or may run on a separate server that accesses storageserver 174.

In one embodiment, a build-update graph 180 builds or updates a socialgraph using the collected activity data. The social graph can be storedin one or more databases or file systems. In one embodiment,build-update graph 180 can include three components: (1) identify nodesand edges for social graph that need to be updated, (2) create newnodes/edges if nodes/edges are not found, and (3) update valuesassociated with nodes and edges.

For the incoming activity data collected, identify nodes 182 scanthrough and find the nodes and edges of the social graph that need to beupdated.

When system 32 is processing a user activity data it has the ID of thepatient monitoring device 10 user and attributes this activity to thatpatient monitoring device 10 user.

When a node or edge is found, update values update the node or an edge(e.g., associated with the node). When a node or edge is not found, anew node or edge is created in the graph. The result of build/updategraph is a social graph 184 with nodes modeling user profiles and edgemodeling sharing activities among users.

FIG. 23 shows a sample social graph 186 where circles 188 representnodes and lines are edges 190 representing sharing interactions betweennodes 182. There can be one or more edges 190 between two nodes 182.Several edges 190 between nodes 182 can indicate sharing activitiesalong several categories: e.g., travel, computers, sports, and others.

Nodes 182 connected together directly have one degree of separation.Nodes 182 connected through one other node have two degrees ofseparation. Depending on a number of intervening nodes 182 between twonodes 182, this will be a number of degrees of separation between thetwo nodes 182.

In a specific implementation, edges 190 between nodes 182 indicatesharing activities along several categories such as travel, computers,sports, and the like. For each additional new sharing category, anadditional edge 190 is added. In a specific implementation, for eachadditional new sharing interest category, an additional edge 190 isadded. Further, in an implementation, the sharing interaction or edges190 between the nodes 182 can be weighted (e.g., weighting in a rangefrom 0 to 1), so that certain types of sharing interactions are givendifferent significance. Weight can be used to represent a relativestrength of interaction related to a particular interest category.

Some types of sharing activities that are tracked for the social graph(or share graph) include: sending messages between users; sending filesbetween users; sending videos between users; sending an e-mail (e.g.,Web e-mail) with a link from one user to another such as sharing a linkto various social media sites; and sending instant messages betweenusers. For mobile devices 74 the sharing activities can further include:sending SMS-type messages between users. In some embodiments, messagescan be sending from wearable devices 10.

Once two users connect, such as one patient monitoring device 10 sendinganother patient monitoring device 10 user a message containing a linkconcerning a topic. When the recipient user clicks on the link from thesender user, system 32 will add an edge 190 to graph 186 to representthe activity. An edge 190 is added to the graph 186 to represent thissharing activity between the two users.

In a specific implementation, two patient monitoring device 10 users areconnected when one user (sender) shares information with another user orgroup and the other user (recipient) consumes the information that wassent (e.g., clicked-back on the shared link, opened an attachment,opened a message). For example, simply placing a link on Facebook® wallso that all Facebook® “friends” can see this link or tweeting a link toTwitter® followers will not create a connection between the sender, orsharer, and people in the graph. This would create significant noise inthe system. The connections are created between the sender and onlythose users who clicked back on (or otherwise consumed) the message.

In one embodiment of the present invention, illustrated in FIG. 24, thepatient monitoring device 10 includes the alarm 44. In one embodiment,the alarm 44 sends a message to the patient only when the patient isawake. The awake status of the patient can be determined by themonitoring device 10 itself, the monitoring device 10 in combinationwith the telemetry system 32, or by the telemetry system 32.

The alarm 44 can be visual, by motion, audio, and the like. The patientmonitoring device 10 can include a visual display 42 that cancommunicate an alert to the patient. In another embodiment, the alarm 44can provide an audio alert to the patient.

The display 42 can be a touch screen display, such that the patient or abystander can communicate with the telemetry system 32.

In one embodiment, the monitoring device 10 detects and awake ornon-awake status of the patient. The alarm 44 is then activated when thepatient is alert or awake, when an alert is required.

In FIG. 24, the alarm 44 is positioned at patient monitoring device 10.Sensors 14 are to the processor 18 in order to determine if the patientis awake. When the patient is awake, and a condition exists that meritsthe patient receiving an alert, the processor 84 communicates with analarm circuit 216 coupled to the display 42 or the audio alarm 44 andprovide an alert to the patient regarding the patient's condition, achange in a patient parameter, a hazard, and the like.

The determination that the patient is awake can be made by a variety ofmethods. As non-limiting examples, sleep detection, e.g., awakeness ofthe patient, can be by, motion detection, breathing rate, respiratoryfunction, brain activity, visual detection, eyelid activity, imagedetection and the like.

In one embodiment, the determination for the awake condition of thepatient is determined at the telemetry system 32. In this embodiment,when a patient needs to receive an alert by alarm 44, display 42, andthe like, the telemetry system 32 sends a wireless signal to themonitoring device 10. The signal can be sent to the processor 84,circuit 216, transceiver 86 and the like. If the patient is awake, thenan alert is created and transmitted to the patient via, audio, visual,touch and the like.

The foregoing description of various embodiments of the claimed subjectmatter has been provided for the purposes of illustration anddescription. It is not intended to be exhaustive or to limit the claimedsubject matter to the precise forms disclosed. Many modifications andvariations will be apparent to the practitioner skilled in the art.Particularly, while the concept “component” is used in the embodimentsof the systems and methods described above, it will be evident that suchconcept can be interchangeably used with equivalent concepts such as,class, method, type, interface, module, object model, and other suitableconcepts. Embodiments were chosen and described in order to bestdescribe the principles of the invention and its practical application,thereby enabling others skilled in the relevant art to understand theclaimed subject matter, the various embodiments and with variousmodifications that are suited to the particular use contemplated.

What is claimed is:
 1. A system for using telemetry data based on apatient habit information or patient monitoring, comprising: one or morepatient monitoring devices that has a unique patient ID and acquirespatient information selected from the group consisting of, a patient'sactivities, behaviors and habit information, and patient monitoring, thepatient monitoring device configured to provide a change of data capturefrequency of at least one sensor and the ability to change how often thepatient monitoring device samples at least one sensor based on receivedsensor data, the patient monitoring device configured to identify apatient based on a patient movement pattern and one or more patienthabits; ID circuitry at the patient monitoring device, the ID circuitryincluding ID storage, a communication system that reads and transmitsthe unique patient ID from an ID storage, a power source and a pathwaysystem to route signals through the ID circuitry; an alarm at a patientmonitoring device that in operation only provides an alert when thepatient is in a wake-state; and a telemetry system in communication withthe patient monitoring device, the telemetry system including a databaseof patient ID's.
 2. The system of claim 1, wherein, the telemetry systemanalyzes telemetry data received from the patient monitoring devicebased on the group consisting of, patient's activities, behaviors andhabit information, patient condition, and patient parameter, and createspersonalized information about the patient.
 3. The system of claim 1,wherein an awake status of the patient is determined by the patientmonitoring device itself, the patient monitoring device in combinationwith the telemetry system, or the telemetry system.
 4. The system ofclaim 1, wherein the alarm is selected from the group consisting of,visual, motion, audio, and vibratory.
 5. The system of claim 1, furthercomprising: a visual display at the patient monitoring device.
 6. Thesystem of claim 5, wherein the visual display is a touch screen display.7. The system of claim 1, wherein the patient monitoring device includesa processor.
 8. The system of claim 1, wherein an awake state of thepatient is determined by the group consisting of, motion detection,breathing rate, respiratory function, brain activity, visual detection,eyelid activity and image detection.
 9. The system of claim 1, whereinthe system performs patient medical monitoring selected from the groupconsisting of, cardiac, hemodynamic, respiratory, respiratory rate,hemodynamic, blood pressure, pulse oximetry, capnography, respiratory,neurologic, blood glucose, childbirth, body temperature, stress,epilepsy and toxicity.
 10. The system of claim 9, wherein a medicalmonitoring device includes the group consisting of, aelectrocardiography device or sensor, a Holter monitor, a cardiac outputmonitor, a Swan-Ganz catheter a blood pressure monitor, a pulseoximeter, an infrared finger cuff, a capnography monitor for CO2measurements, an airway respiratory rate monitor, a transducer belt, anECG channel, a neurological monitor, an intracranial monitor, a brainwave monitor, an anesthetic monitor, a bispectral index, blood glucosesensor, one or more childbirth monitors, body monitor, a thermoelectrictransducer, a stress monitor, an epilepsy monitor and a toxicitymonitor.
 11. The system of claim 1, further comprising: a control systemat the patient monitoring device to orchestrate communication between adifferent systems.
 12. The system of claim 1, further comprising: anoise reduction element at the patient monitoring device to reducesignal noise. 13.-16. (canceled)
 17. The system of claim 15, wherein theconditioning electronics clean a signal for processing by a centralprocessing unit (CPU) of the telemetry system.
 18. The system of claim17, wherein the CPU evaluates historical data.
 19. The system of claim1, wherein the telemetry system in operation creates differentclassifications for data received from the patient monitoring device.20. The system of claim 19, wherein the different classifications areselected from the group consisting of, a patient's location, where thepatient spends its time, with whom the patient spends its time, adetermination of working relationships, a determination of familyrelationships, a patient's activities, and a patient's socialrelationships.
 21. The system of claim 1, wherein the telemetry systemin operation provides firmware updates to the patient monitoring device.22. The system of claim 1, wherein streams of information are sent fromat least one sensor at the patient monitoring device to the telemetrysystem.
 23. The system of claim 22, wherein the streams of informationcan include encrypted and non-encrypted information.
 24. The system ofclaim 23, wherein patient information is sent from the patientmonitoring device to a mobile device or computer.
 25. A method for usingtelemetry data based on a patient habit information or patientmonitoring, comprising: acquiring patient information using a patientmonitoring device, the patient information selected from the groupconsisting of, a patient's activities, behaviors and habit information,and patient monitoring; providing a change of data capture frequency ofat least one sensor and an ability to change how often the patientmonitoring device samples at least one sensor based on received sensordata; identifying the patient based on a patient movement pattern andone or more wearer habits; transmitting a unique ID of the patientmonitoring device from the patient monitoring device to a telemetrysystem; communicating between the patient monitoring device and thetelemetry system; and sending an alert to a patient that has the patientmonitoring device when the patient is in a wake-state.
 26. The method ofclaim 25, further comprising: analyzing telemetry data received from thepatient monitoring device based on at least one of, patient'sactivities, behaviors and habit information, patient condition, andpatient parameter, and creates personalized information about thepatient.
 27. The method of claim 25, further comprising: determining apatient awake status by the patient monitoring device itself, thepatient monitoring device in combination with the telemetry system, orthe telemetry system.
 28. The method of claim 25, wherein an alarm isselected from the group consisting of, visual, motion, audio, andvibratory.
 29. The method of claim 25, further comprising: using avisual display at the patient monitoring device to send the alert. 30.The method of claim 25, further comprising: determining an awake stateof the patient by at least one of, motion detection, breathing rate,respiratory function, brain activity, visual detection, eyelid activityand image detection.
 31. The method of claim 25, further comprising:performing patient medical monitoring selected from the group consistingof, cardiac, hemodynamic, respiratory, respiratory rate, hemodynamic,blood pressure, pulse oximetry, capnography, respiratory, neurologic,blood glucose, childbirth, body temperature, stress, epilepsy andtoxicity.
 32. The method of claim 31, further comprising: performingpatient medical monitoring using the group consisting of, aelectrocardiography device or sensor, a Holter monitor, a cardiac outputmonitor, a Swan-Ganz catheter a blood pressure monitor, a pulseoximeter, an infrared finger cuff, a capnography monitor for CO2measurements, an airway respiratory rate monitor, a transducer belt, anECG channel, a neurological monitor, an intracranial monitor, a brainwave monitor, an anesthetic monitor, a bispectral index, blood glucosesensor, one or more childbirth monitors, body monitor, a thermoelectrictransducer, a stress monitor, an epilepsy monitor and a toxicitymonitor.
 33. The method of claim 25, further comprising: reduce signalnoise at the patient monitoring device. 34.-35. (canceled)
 36. Themethod of claim 25, further comprising: creating differentclassifications for data received from the patient monitoring device atthe telemetry system.
 37. The method of claim 36, wherein the differentclassifications are selected from the group consisting of, a patient'slocation, where the patient spends its time, with whom the patientspends its time, a determination of working relationships, adetermination of family relationships, a patient's activities, and apatient's social relationships.
 38. The method of claim 25, furthercomprising: providing firmware updates to the patient monitoring device.39. The method of claim 25, further comprising: sending patientinformation from the patient monitoring device to a mobile device orcomputer.